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即刻植入和临时修复在美学区域的种植体:一项为期 1 年的随机对照试验和体积研究。

Immediate placement and provisionalization of implants in the aesthetic zone with or without a connective tissue graft: A 1-year randomized controlled trial and volumetric study.

机构信息

Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Department of Fixed and Removable Prosthodontics and Dental Material Science, School of Dental Medicine, University of Zurich, Zurich, Switzerland.

出版信息

Clin Oral Implants Res. 2018 Jul;29(7):671-678. doi: 10.1111/clr.13258. Epub 2018 May 27.

Abstract

OBJECTIVE

To volumetrically compare peri-implant mid-facial soft tissue changes in immediately placed and provisionalized implants in the aesthetic zone, with or without a connective tissue graft.

MATERIAL AND METHODS

Sixty patients were included. All implants were placed immediately after extraction. After randomization, in one group, a connective tissue graft (test group, n = 30) was inserted at the buccal aspect of the implant. The other group (control group, n = 30) received no connective tissue graft. Clinical parameters, digital photographs and conventional impressions were obtained before extraction (T ) and at 12 months following definitive crown placement (T ). The casts were digitized by a laboratory scanner, and a volumetric analysis was performed between T and T .

RESULTS

Twenty-five patients in each group were available for analysis at T . Volumetric change, transformed to a mean (±SD) change in thickness, was -0.68 ± 0.59 mm (test) and -0.49 ± 0.54 mm (control) with a non-significant difference between groups (p = .189). The mid-facial mucosa level was significantly different between both groups (p = .014), with a mean (±SD) change of +0.20 ± 0.70 mm (test) and -0.48 ± 1.13 mm (control). The Pink Esthetic Score was similar between both groups.

CONCLUSIONS

The use of a CTG in immediately placed and provisionalized implants in the aesthetic zone did not result in less mucosal volume loss after 12 months, leading to the assumption that a CTG cannot fully compensate for the underlying facial bone loss, although a significantly more coronally located mid-facial mucosa level was found when a CTG was performed.

摘要

目的

定量比较在美学区域中即刻植入和临时植入的种植体周围颊侧软组织的变化,比较是否使用了结缔组织移植。

材料和方法

共纳入 60 名患者。所有种植体均在拔牙后即刻植入。随机分组后,一组在种植体颊侧插入结缔组织移植(实验组,n=30),另一组(对照组,n=30)不使用结缔组织移植。在拔牙前(T )和最终修复体放置后 12 个月(T )时,分别记录临床参数、数字照片和常规印模。使用实验室扫描仪对模型进行数字化,在 T 和 T 之间进行体积分析。

结果

每组各有 25 名患者在 T 时可进行分析。体积变化,转换为厚度的平均(±SD)变化,实验组为-0.68±0.59mm,对照组为-0.49±0.54mm,两组间无显著差异(p=0.189)。两组间颊侧黏膜水平差异有统计学意义(p=0.014),实验组平均(±SD)变化为+0.20±0.70mm,对照组为-0.48±1.13mm。两组的 Pink 美学评分相似。

结论

在美学区域中即刻植入和临时植入的种植体中使用结缔组织移植并不能减少 12 个月后黏膜体积的丧失,这表明结缔组织移植不能完全补偿颊侧骨的丧失,尽管当使用结缔组织移植时,发现颊侧黏膜的冠向位置更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba53/6099353/8ec251724225/CLR-29-671-g001.jpg

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